Development of inflammatory bowel disease during anti-TNF-α therapy for inflammatory rheumatic disease. A nationwide series

OBJECTIVES: To describe cases of new onset of inflammatory bowel disease (IBD) in patients with inflammatory rheumatic disease (IRD) receiving anti-TNF-α therapy. METHODS: A call for observations of such cases was sent to members of the French "Club rhumatismes et inflammation". Only patients without intestinal symptoms before introduction of anti TNF-α agents were included. RESULTS: During a 2-year period, 16 patients were declared: nine men and seven women, mean age 41.5±17.4 years, 12 patients with ankylosing spondylitis, one with rheumatoid arthritis, one with psoriatic arthritis and two juvenile idiopathic arthritis with enthesitis related arthritis. Overall, 14 patients received etanercept and two had infliximab. The meantime frame between onsets of anti-TNF--α drugs and development of IBD was 29.3±20.1 months. According to endoscopic and histological findings, IBD was classified as typical Crohn's disease in eight cases, Crohn's-like disease in six cases, indeterminate in one case and definite ulcerative colitis in one case. For all cases, each TNF-α blocking agent was discontinued and replaced by another monoclonal anti TNF-α antibody. After a mean follow up period of 23.4±19.5 months, outcome was favorable without recurrent or flaring IBD. CONCLUSIONS: Paradoxical IBD may occur during anti TNF-α therapy for inflammatory rheumatic disease, mostly in patients with spondylarthropathies while receiving etanercept, at a frequency estimated to 0.15% in the French patients with spondylarthropathies exposed to TNF-α antagonists. The IBD mainly corresponded to Crohn's or Crohn's-like disease. On the contrary, new onset IBD is less frequently observed in other cases of IRD and with other TNF--α blockers.     

����ǣ��������򢴽���������������ܼ�����Ч������

??Objective    To evaluate the clinical appearance and periodontal status of impacted maxillary central incisors that had been exposed and aligned after a closed-eruption orthodontic surgical technique. Methods    The subjects consisted of 18 patients who were treated in  Stomatology Hospital of Yantai from 2011 to 2015. Examinations were done after orthodontic treatment for the unilateral labially impacted maxillary central incisors 3 months after retention. The clinical and radiographic variables were compared by SPSS 17.0 software package. Results    The treated central incisors showed no significant difference in plaque and gingival indexes??width of attach gingival or pocket depth??whereas a small but statistically significant increase was found in the clinical crown lengths. The bone support was reduced in the treated incisors??whereas in 4 of the control central incisors??abnormal gingival contour was recorded. Conclusion    This study demonstrates that the overall esthetic and periodontal results can be achieved by treating impacted maxillary central incisors with a closed-eruption orthodontic surgical technique. However??a long term follow-up study on the esthetic outcome is recommended.     

重症腺病毒肺炎临床特点及并发闭塞性细支气管炎危险因素分析

目的　总结重症腺病毒肺炎（severe adenovirus pneumonia,SAP）的临床特点,分析其并发闭塞性细支气管炎（bronchiolitis obliterans,BO）的危险因素。方法　对南京医科大学附属儿童医院呼吸科2017年1月至2019年12月住院的125例SAP患儿进行回顾分析,总结其临床特点。根据是否发展为BO将患儿分为BO组和非BO组,并对临床资料进行分析。结果　发病年龄≤24月龄80例（64%）;热峰≥39℃者115例（94.3％）,热程≥10 d者89例（72.9％）;气喘82例（65.6%）;单纯腺病毒感染35例（28%）,72%的患儿合并其他病原体感染［肺炎支原体（MP）40.8%,细菌35.2%］;并发呼吸衰竭32例（25.6%）,肺外并发症以循环系统（36%）和消化系统并发症（22.4%）多见。实访122例SAP患儿,53例（43.4%）最终发展为BO。多因素Logistic回归分析显示呼吸衰竭和合并MP感染是SAP后BO的独立危险因素（P＜0. 05）。结论　SAP主要发生于2岁以下的婴幼儿,多为高热且持续时间长,多数患儿存在喘息,混合感染率高;最常见的并发症是呼吸衰竭、 心功能不全、 肝功能损害和中毒性脑病。呼吸衰竭和合并MP感染是SAP后BO的独立危险因素。     

9th month (P<0.05).There was a significant di

n cognition ability at 9th month too (P<0.05).Conclusion The baby touch that begins at early time after birth may benefit the neurological and psychological development of the infants and has a long-based effect.Baby touch Intelligence development Different phase0中国全科医学Chinese General Practice36-37R174E055;E069;72;2;EE055_72;E069_2;郭建华000900030001;000900030008000200010003;0009000300040015000230-31影响婴儿出生体重的高危因素分析张勇,王燕,朱鹃,范钦颖中日友好医院预防保健科 ,中日友好医院预防保健科 ,中日友好医院预防保健科 ,中日友好医院预防保健科 100029北京市,100029北京市,100029北京市,100029     

血制品与止血药同时输注所致过敏性休克的救治体会

病例：单某，男，35岁，农民，住院号：117441。患者因右肱骨干骨折并神经损伤术后骨折未愈合，内固定钢板折弯，桡神经损伤于2002年3月11日收住院。入院体查：神清，精神好，双肺呼吸音清，未闻及干湿性罗音，心界不大，律齐，各瓣膜区未闻及杂音，腹软无压痛及反跳痛，肝脾未及，双下肢不肿。专科检查：右上臂前外侧有一长约10cm的手术瘢痕无     

Kongenitaler Tumor des temporalen Lidwinkels

Ohne Zusammenfassung     

Autologous bone marrow stem cell or peripheral blood endothelial progenitor cell therapy in patients with peripheral limb ischaemia

No effective medical therapies have been developed sofar to enhance blood flow in the legs of patients with peripheral arterial disease (PAD). For patients with limb threatening ischaemia the only option for relief of rest pain or gangraena is amputation. There is evidence in experimental and clinical studies that adult bone marrow-derived stem cells and endothelial progenitor cells participate in the development of new blood vessels, called neoangiogenesis or neovascularization. Clinical results induced by autologous bone marrow stem cells or angiogenic growth/differentiation factors in end-stage patients with PAD are summarized. Considering the relatively few number of patients treated by angiogenic therapy, the interpretation of clinical results needs cautiousness.     

Stabilisation of periprosthetic fractures with angular stable internal fixation: a report of 13 cases

Introduction: Periprosthetic fractures of the femur present a challenging surgical problem. The aim of this study was to retrospectively evaluate the outcome of periprosthetic fractures stabilised with an angular stable, less invasive stabilisation system (LISS). Patients and methods: Thirteen patients (ten total hip-, two total knee-, one total hip- and knee-arthroplasty) with periprosthetic fractures were treated with the LISS internal fixator (in ten cases minimal invasive). Six patients had previous operations due to periprosthetic fractures. The average follow-up period was 20 months, follow-up rate 85%. Results: All fractures showed radiographic fracture healing without implant loosening. Except one patient, all patients had returned to their pre-operative activity level. No early post-operative complications were seen. There was one implant failure after 4 months and two cases of malunion. Conclusion: The cases showed the internal fixator to be effective for the stabilisation of periprosthetic fractures, even in cases of poor bone quality with good functional outcomes. The internal fixator, with the option of minimal invasive application, is the preferred method of osteosynthesis in periprosthetic fractures.